Management of Coeliac disease
Clinical features in childhood:
• usually presents at 9–18 mths, but any age
• previously thriving infant
• anorexia, lethargy, irritability
• failure to thrive
• malabsorption: abdominal distension
• offensive frequent stools
Diagnosis:
• characteristic duodenal biopsy—villous atrophy (gold standard test)
• IgA markers
serum antigliadin (limited value), anti-endomysial and
transglutaminase Abs—90% sensitivity and specifi city
Treatment: remove gluten from diet
Note: Coeliac disease can occur at any age.
Classic triad: diarrhoea, weight loss, iron defi ciency.
Clinical features in childhood:
• usually presents at 9–18 mths, but any age
• previously thriving infant
• anorexia, lethargy, irritability
• failure to thrive
• malabsorption: abdominal distension
• offensive frequent stools
Diagnosis:
• characteristic duodenal biopsy—villous atrophy (gold standard test)
• IgA markers
serum antigliadin (limited value), anti-endomysial and
transglutaminase Abs—90% sensitivity and specifi city
Treatment: remove gluten from diet
Note: Coeliac disease can occur at any age.
Classic triad: diarrhoea, weight loss, iron defi ciency.